| 特集名 | 腎不全における悪性腫瘍 | |
|---|---|---|
| 題名 | 透析患者における悪性腫瘍(統計的分析) (2) 諸外国の状況 | |
| 発刊年月 | 2001年 06月 | |
| 著者 | 大平 整爾 | 日鋼記念病院外科・腎センター |
| 著者 | 伊丹 儀友 | 日鋼記念病院外科・腎センター |
| 著者 | 辻 寧重 | 日鋼記念病院外科・腎センター |
| 【 要旨 】 | 透析患者の癌発生に関しては，一般人口に比較して多発するとする報告が多い．本論では慢性透析831,804例を分析したMaisonneuveらの文献を中心に，国外の状況を探った． 慢性透析患者では総体的に癌は多発しているが，透析導入1年未満以内の診断例が多い． 透析開始前の尿毒症状態が，発癌に関連している可能性が大きい．一部の腎癌のごとく透析歴の延長により増加する癌腫では，長期透析の影響が示唆される．若年群がもっとも高い癌発生リスクを示した点はきわめて注目すべきであろう．Maisonneuveらにより解析された症例は本邦の透析例と年齢構成，透析期間などの諸点で差異があるため，その結果をただちには本邦に演繹できないものであろう．わが国独自に，この領域の広範囲な統計的な検索が求められる． |
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| Theme | Malignancy in Chronic Renal Failure | |
|---|---|---|
| Title | Malignant tumors in chronic dialysis patients -- Review of foreign literature | |
| Author | Seiji Ohira | Department of Surgey and Kidney Center, Nikko Memorial Hospital |
| Author | Noritomo Itami | Department of Surgey and Kidney Center, Nikko Memorial Hospital |
| Author | Yasushige Tsuji | Department of Surgey and Kidney Center, Nikko Memorial Hospital |
| [ Summary ] | There are many papers which report a higher incidence of malignant tumors in the chronic dialysis population compared to general population. In this review, the foreign situation was investigated with the paper of Maisonneuve et al. (Lancet 354: 93-99, 1999) as the central basis. Chronic dialysis patients, in general, have a relatively high cancer risk, with the greatest number of cancers being discovered within the first year after initiating dialysis. It is highly possible that the predialytic uremic condition is a related carcinogenic factor. In one type of renal cancer, the incidence rate increases the longer dialysis treatment continues and one must wonder if long term dialysis itself has influence on the carcinogenesis. One surprising observation is the extremely high risk of cancer in the younger group of dialysis patients (<35 years). As the cases analyzed by Maisonneuve et al differed in several aspects from those in Japan, we must be careful when applying their results to our own cases. There is an urgent need for this type of data to be collected and analyzed in Japan, which now takes care of about 200,000 dialysis patients. |
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